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Transthoracic echocardiography reliable for assessing regurgitation severity after TAVI

13 Oct 2019

Despite being somewhat discordant with cardiac magnetic resonance (CMR), two-dimensional transthoracic echocardiography (2D TTE) is able to sufficiently distinguish between severe and mild or no residual aortic regurgitation (AR) after transcatheter aortic valve implantation (TAVI), a recent study has found.

Researchers performed a systematic review and meta-analysis of seven studies retrieved from the online databases of PubMed, Embase and the Cochrane Central Library. Studies that compared 2D TTE with CMR for post-TAVI AR assessment were eligible. The cumulative sample included 300 patients (mean weighted age, 82 years; 61 percent male).

Only four studies qualified for quantitative analysis; the other three either provided incomplete data or used a different reference standard.

Pooled analysis of the four eligible studies revealed that 2D TTE was able to detect moderate or severe AR reliably, as determined by hierarchical summary receiver operating curve characteristic analysis (area under the curve [AUC], 0.83, 95 percent CI, 0.79–0.86).

Agreement between TTE and CMR was low. Cohen’s kappa coefficient values ranged from –0.02 to 0.72. Three studies concluded poor agreement between the two while two showed fair agreement. Only one study apiece suggested that there was moderate and good agreement between TTE and CMR.

“Therefore, we recommend TTE for the initial evaluation of AR severity in all patients post TAVI, whereas CMR should follow only where there is discrepancy with the clinical assessment, when TTE results are equivocal or difficult to obtain,” said researchers.

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Most Read Articles
Pearl Toh, 20 Nov 2019
The trade-off between the risk of ischaemic vs bleeding events may be different between Asian and non-Asian patients, which warrants careful consideration when deciding on the duration of antiplatelet therapy following a percutaneous coronary intervention (PCI), according to a presentation at ESC Asia Congress 2019.
4 days ago
Participating in a long-distance skiing event may help lower the risk of hypertension, with the number of completed races showing a weak association with the risk, a study has found.
06 Sep 2019
Hypertensive adults with lower plasma zinc concentration are at increased risk of haemorrhagic stroke, especially those with higher body mass index or lower plasma copper levels, a study has found.
06 Jan 2020
Target organ damage appears to be more noticeable in patients affected by primary aldosteronism than those affected by arterial hypertension without primary aldosteronism, suggests a study, adding that specific treatment can ease such condition.